Baseline characteristics, grading and mortality in acute on chronic liver failure using CLF-C ACLF CRITERIA.

Authors

  • Marium Fatima Waqar Jinnah Postgraduate Medical Centre, Karachi, Pakistan.
  • Falak Naz Jinnah Postgraduate Medical Centre, Karachi, Pakistan.
  • Zeeshan Ali Jinnah Postgraduate Medical Centre & JSMU, Karachi, Pakistan.
  • Shabnam Naveed Jinnah Postgraduate Medical Centre & JSMU, Karachi, Pakistan.
  • Syed Masroor Ahmed Jinnah Postgraduate Medical Centre & JSMU, Karachi, Pakistan
  • Sulhera Khan Jinnah Postgraduate Medical Centre, Karachi, Pakistan.

DOI:

https://doi.org/10.29309/TPMJ/2023.30.07.7510

Keywords:

ACLF Grading, Precipitating Factors

Abstract

Objective: To observe baseline characteristics, ACLF (Acute on Chronic Liver Failure) grading and mortality in ACLF patients using EASL CLIF CRITERIA. Study Design: Prospective, Observational study. Setting: Medical unit 111, ward 7, Jinnah Postgraduate Medical Centre, Karachi. Period: January 2022 to June 2022. Material & Methods: We prospectively analysed data of hospitalised liver cirrhosis patients at a tertiary care hospital in Karachi, Pakistan. The data was analysed in SPSS version 25. Results: There were a total of 43 ACLF patients, with the median age of IQR of 56(47-62) years, out of which 20 (46.5%) patients were male and 23 (53.5%) were females. The most common etiology of liver cirrhosis was hepatitis C 26(60.5%) followed by other etiologies nine (20.9%) and hepatitis B eight (18.6%). The most common precipitating factor was infection 19(44.2%) and the most frequent organ failure (OF) was renal failure (60.5%), followed by cerebral failure (46.5%) and other OFs. There were 24 patients in ACLF grade one, 13 in grade two and six in grade three ACLF. All six patients of ACLF grade three belonged to CTP C (Child-turcotte-pugh Cirrhosn) (100%) with 100% mortality. ACLF grade two had nine (69.2%) and ACLF grade one had eight (33.33%) CTP C patients. The in hospital mortality of ACLF was 23%. The median MELD Na of these patients was 28 (23-31), CLIF Consortium Organ Failure score was 9(8-10) and CLIF C ACLF Score was 45 (38-55). Conclusion: Highest mortality was observed in Child Pugh C and ACLF grade three in our patients. Such patients must be closely monitored and referred early for medical management and liver transplantation.

Author Biographies

Marium Fatima Waqar, Jinnah Postgraduate Medical Centre, Karachi, Pakistan.

FCPS, Consultant Physician Medicine (JPMC), Medical Unit III, Ward 7, 

Falak Naz, Jinnah Postgraduate Medical Centre, Karachi, Pakistan.

MBBS, Resident Medical Unit 111, Ward 7, 

Zeeshan Ali, Jinnah Postgraduate Medical Centre & JSMU, Karachi, Pakistan.

FCPS, Associate Professor and Head Ward 23, Medical ICU, Unit 1V, 

Shabnam Naveed, Jinnah Postgraduate Medical Centre & JSMU, Karachi, Pakistan.

FCPS, Associate Professor Medicine (JPMC), Medical Unit III, Ward 7, 

Syed Masroor Ahmed, Jinnah Postgraduate Medical Centre & JSMU, Karachi, Pakistan

FCPS, Professor and Head Medicine, Medical Unit III, Ward 7, 

Sulhera Khan, Jinnah Postgraduate Medical Centre, Karachi, Pakistan.

MBBS, Resident, Medical Unit 111, Ward 7, 

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Published

2023-07-02